NPIMap

Organization Active NPI

Sanford Clinic

Doing business as Sanford Gynecologic Oncology Clinic

  • Gynecologic Oncology Physician
  • Sioux Falls, SD
National Provider Identifier
1396089900
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
Legal business name
SANFORD CLINIC
Doing business as
Sanford Gynecologic Oncology Clinic
Practice address
1309 W 17TH St Ste 102
Sioux Falls, SD 57104-4663
Phone
(605) 312-3250
Fax
(605) 312-3251
NPI assigned
Nov 20, 2012
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tony Lee Morrison
Title
Vice President, Revenue Cycle
Phone
(605) 328-8380

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X
Gynecologic Oncology Physician 207VX0201X Primary

Addresses

Primary practice location

1309 W 17TH St Ste 102
Sioux Falls, SD 57104-4663

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other names 1

  • Sanford Gynecologic Oncology Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031110000532 SD Part B Supplier - Clinic/Group Practice 0244143824 Receives reassigned benefits from 941 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Sioux Valley Clinic33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

  • Sanford Clinic

    dba Sanford 69th & Louise Family Medicine

    • Family Medicine Physician
    • Sioux Falls, SD
    • NPI 1104255835
    NPD tax ID
  • Sanford Clinic

    dba Sanford Health Lake Lorraine Eye Clinic

    • Clinic/Center
    • Sioux Falls, SD
    • NPI 1164069506
    NPD tax ID
  • Sanford Clinic

    dba Sanford Clinic Breast Health Institute

    • Radiation Oncology Physician
    • Sioux Falls, SD
    • NPI 1174537799
    NPD tax ID
  • Sanford Clinic

    dba Sanford Medical Genetics Laboratory

    • Clinical Medical Laboratory
    • Sioux Falls, SD
    • NPI 1346410115
    NPD tax ID
  • Sanford Clinic

    dba Sanford Acute Care 69th & Minnesota Clinic

    • Family Medicine Physician
    • Sioux Falls, SD
    • NPI 1366450835
    NPD tax ID
  • Sanford Clinic

    dba Sanford Children's 69th & Louise Clinic

    • Pediatrics Physician
    • Sioux Falls, SD
    • NPI 1386072569
    NPD tax ID
  • Sanford Clinic

    dba Sanford Children's Residency Clinic

    • Pediatrics Physician
    • Sioux Falls, SD
    • NPI 1437438306
    NPD tax ID
  • Sanford Clinic

    dba Sanford 26th and Sycamore Family Medicine

    • Family Medicine Physician
    • Sioux Falls, SD
    • NPI 1447289343
    NPD tax ID
  • Sanford Clinic

    dba Edith Sanford Breast Specialty Clinic

    • Family Medicine Physician
    • Sioux Falls, SD
    • NPI 1497163026
    NPD tax ID
  • Sanford Clinic

    dba Sanford Health Lake Lorraine Eye Clinic

    • Eyewear Supplier
    • Sioux Falls, SD
    • NPI 1518599562
    NPD tax ID
  • Sanford Clinic

    dba Sanford Clinic Gastroenterology

    • Gastroenterology Physician
    • Sioux Falls, SD
    • NPI 1518973221
    NPD tax ID
  • Sanford Clinic

    dba Sanford Diabetes and Thyroid Clinic

    • Endocrinology, Diabetes & Metabolism Physician
    • Sioux Falls, SD
    • NPI 1578589677
    NPD tax ID
View all 32

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1396089900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585",
            "fax_number": "605-328-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 W 17TH ST STE 102",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571044663",
            "telephone_number": "605-312-3250",
            "fax_number": "605-312-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-20",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-30",
        "status": "A",
        "authorized_official_last_name": "MORRISON",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "VICE PRESIDENT, REVENUE CYCLE",
        "authorized_official_telephone_number": "605-328-8380"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Sanford Gynecologic Oncology Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sanford Gynecologic Oncology Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.